Safety of Breastfeeding With Infliximab Use

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My daughter receives Remicade [infliximab] for her Crohn's. She recently had a baby and wanted to breastfeed but got many different views on the safety of doing this and what effects it would have on her baby. Please give your opinion.

The answer to your question is unknown. What is known is that infliximab is considered a class B drug and is likely to be safe during pregnancy, especially if the mother needs it to stay well. Antibodies are passively transferred to the baby in breast milk. Indeed, breast milk is an important source of immune defense for the baby. It is not unreasonable to conclude that the baby is receiving infliximab in the breast milk of a mother treated with infliximab and is therefore immunosuppressed like the mother. I suppose that this adds up to the conclusion that your daughter should not receive infliximab while she is breastfeeding, or if she needs infliximab should not breastfeed.

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